Utilization Review Registered Nurse

2 weeks ago


Camden, New Jersey, United States Cooper University Health Care Full time
About Us

At Cooper University Health Care, we prioritize exceptional health care through our dedicated team. Our skilled professionals are at the forefront of clinical advancements, ensuring access to the latest facilities, equipment, technologies, and research methodologies. We are committed to our employees by offering competitive compensation, comprehensive benefits, favorable working conditions, and opportunities for career growth through professional development.

Discover why Cooper University Health Care stands out as the employer of choice in South Jersey.

Short Description

The Utilization Review Registered Nurse employs payer-specific assessment tools to aid in evaluating the level of service and medical necessity. This role involves conducting utilization reviews in compliance with all state regulations.

Engagement with the Physician Advisor is essential to discuss matters of medical necessity, length of stay, and care appropriateness.

Proactively identify and manage concurrent and retroactive denials through effective communication with attending physicians, case management, multidisciplinary teams, external physician resources, and payers. Document the review and denial processes within the EPIC Case Management Module.

Respond to payer requests for necessary information and treatment plans. Review and confirm physician orders, reporting progress and any unusual occurrences related to patients to the payer.

Experience Required

A minimum of 5 years of recent clinical experience, ideally within a specialized population area.

Experience in utilization management or review is preferred.

Strong knowledge of disease protocols and clinical pathways for both commercial and government payors is essential. Familiarity with Interqual and Milliman guidelines, as well as regulatory mandates, is advantageous.

Excellent communication skills (both written and verbal) and critical thinking abilities are required. Professional presentation skills are also necessary.

Education Requirements

A Bachelor's degree in Nursing is preferred.

License/Certification Requirements

A current NJ-RN License is required.



  • Camden, New Jersey, United States Jackson Nurse Professionals Full time

    Job Title: Traveling Registered NurseJob Type: Travel NursingSpecialty: Operating RoomDiscipline: Registered NurseShift: 12 hours, eveningsEmployment Type: TravelPerks:Day 1 medical and immediate pay options availableShift: 11a-11pAbout Jackson Nurse Professionals:Filling Critical Needs in Patient Care:Jackson Nurse Professionals delivers cost-effective...


  • Camden, New Jersey, United States Planet Healthcare Full time

    Job Title: Traveling Registered NursePlanet Healthcare is seeking a skilled Traveling Registered Nurse to join our team in a dynamic Operating Room environment.Job Summary:We are looking for a highly experienced Operating Room Nurse to work in a high-acuity trauma setting. The ideal candidate will have a strong background in circulating and scrubbing, as...


  • Camden, New Jersey, United States Mitchell Martin Healthcare Full time

    Job Title: Traveling Registered NurseJob Type: Travel NursingLocation: Camden, New JerseyJob Description:Job Summary:Mitchell Martin Healthcare is seeking a skilled and experienced Traveling Registered Nurse to join our team in Camden, New Jersey. As a Traveling Registered Nurse, you will have the opportunity to work in a dynamic and fast-paced environment,...


  • Camden, New Jersey, United States Nightingale Nurses Full time

    Position Overview Nightingale Nurses is currently in search of a dedicated travel nurse specializing in Med Surg / Telemetry for an exciting opportunity. Job Details Specialty: Med Surg / Telemetry Discipline: Registered Nurse (RN) Work Schedule: 36 hours per week Shift: 12-hour night shifts Employment Type This is a travel position, allowing you to...


  • Camden, New Jersey, United States Favorite Healthcare Staffing Full time

    Job Summary:Favorite Healthcare Staffing is seeking an experienced Telemetry Registered Nurse (TEL RN) for a 13-week assignment in a dynamic healthcare setting. As a valued member of our team, you will have the opportunity to work with a dedicated group of professionals who are passionate about delivering exceptional patient care.Responsibilities:Provide...


  • Camden, New Jersey, United States Cooper University Health Care Full time

    REGISTERED NURSE - NEURO ICU Job Type: Part Time Shift: Day Specialty: Critical Care/ER About Cooper University Health Care At Cooper University Health Care, we are dedicated to delivering exceptional health care through our skilled team of professionals. Our commitment to clinical innovation and state-of-the-art facilities ensures that our employees...

  • Registered Nurse

    1 week ago


    Camden, New Jersey, United States Cooper University Health Care. Full time

    About the RoleThe Registered Nurse is a professional caregiver who, as a member of a multidisciplinary healthcare team, assumes responsibility and accountability for a group of patients for a designated time frame. This role involves supervising and providing care to these patients utilizing the nursing process, including the therapeutic use of self.Key...


  • Camden, New Jersey, United States Soliant Full time

    Travel Registered Nurse - ER SpecialistWe are seeking a skilled and dedicated Travel Registered Nurse to join our team in Camden, NJ, and provide high-quality patient care in a fast-paced and dynamic ER environment.Key Responsibilities:Provide direct patient care to individuals experiencing acute medical emergencies, utilizing strong critical thinking and...


  • Camden, New Jersey, United States Jackson Nurse Professionals Full time

    We are seeking a skilled Cardiovascular Operating Room Registered Nurse to join our team at Jackson Nurse Professionals.This CVOR Travel nursing job offers a competitive salary for 40 hours of work per week for 13 weeks.With our agency, you can compare Travel nurse salary from leading Travel nurse agencies in the United States.Key details of this Travel...


  • Camden, New Jersey, United States Cooper University Health Care Full time

    Medical Surgical Registered Nurse - Kelemen 10 **About Us**At Cooper University Health Care, we prioritize exceptional health care through our dedicated team. Our remarkable professionals are consistently exploring clinical advancements and improving access to state-of-the-art facilities, equipment, technologies, and research methodologies. We are committed...

  • Registered Nurse

    2 weeks ago


    Camden, New Jersey, United States RNnetwork Full time

    Position Overview:RNnetwork is actively seeking a dedicated Registered Nurse specializing in Telemetry for a travel nursing opportunity.Key Responsibilities:As a telemetry nurse, you will be essential in observing patients with critical health metrics, ensuring prompt interventions, and delivering exceptional care that can save lives. Your proficiency in...

  • Registered Nurse

    6 days ago


    Camden, New Jersey, United States Cooper University Health Care Full time

    About UsAt Cooper University Health Care, our commitment to providing extraordinary health care begins with our team. Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies, and research protocols. We have a commitment to our employees by providing...

  • Travel Nurse RN

    1 week ago


    Camden, New Jersey, United States Travel Nurse Source Full time

    About the PositionAt Travel Nurse Source, we strive to understand what motivates you as a healthcare professional.Our dedicated recruiters excel at finding the perfect position for you. From day one, your recruiter will be your advocate as you search for your next career opportunity.Post Anesthesia Care Unit Registered Nurse (PACU RN) Position...


  • Camden, New Jersey, United States Cooper University Health Care Full time

    Become a Vital Member of Our Cardiac Care Nursing TeamAt Cooper University Health Care, we are committed to providing outstanding healthcare services through our dedicated team of professionals who prioritize clinical excellence and utilize state-of-the-art facilities, equipment, and research methodologies.We appreciate our staff by offering competitive...

  • Registered Nurse

    2 weeks ago


    Camden, New Jersey, United States Cooper University Health Care Full time

    Position Overview:The Registered Nurse (RN) in the Medical Surgical Unit plays a crucial role in delivering exceptional patient care within a collaborative healthcare environment.About Cooper University Health Care:At Cooper University Health Care, we prioritize the delivery of outstanding healthcare services, supported by our dedicated team of professionals...

  • Registered Nurse

    2 weeks ago


    Camden, New Jersey, United States TotalMed Staffing Full time

    TotalMed Staffing is actively seeking a travel nurse RN specializing in the Operating Room for an exciting travel nursing opportunity.Position OverviewSpecialty: Operating RoomDiscipline: Registered NurseDuration: 13 weeksHours: 40 hours per weekShift Length: 10 hoursEmployment Type: TravelAre you looking for a rewarding Travel Operating Room Nursing...


  • Camden, New Jersey, United States Hired by Matrix Full time

    Join Hired by Matrix as a Travel Nurse! We are currently seeking a dedicated Registered Nurse specializing in PACU - Post Anesthesia Care for an exciting travel nursing opportunity. Position Overview: This role involves providing exceptional patient care in a fast-paced environment, ensuring the highest standards of clinical excellence. Key Responsibilities:...


  • Camden, New Jersey, United States Genie Healthcare Full time

    Job Title: Traveling Intensive Care Unit Registered NurseJob Summary:Genie Healthcare is seeking a highly skilled and experienced Traveling Intensive Care Unit Registered Nurse to join our team. As a Travel ICU RN, you will have the opportunity to work in a dynamic and fast-paced environment, providing top-notch care to patients in...


  • Camden, New Jersey, United States Hired by Matrix Full time

    Job OverviewHired by Matrix is seeking a skilled Emergency Department Registered Nurse to join our team as a travel nurse. This is a fantastic opportunity to work in a dynamic and fast-paced environment, providing high-quality patient care and making a real difference in the lives of those we serve.Key ResponsibilitiesProvide exceptional patient care in the...


  • Camden, New Jersey, United States Cooper University Health Care Full time

    About UsAt Cooper University Health Care, our commitment to delivering exceptional healthcare begins with our team. Our skilled professionals are continually discovering innovative clinical practices and providing access to the latest facilities, equipment, technologies, and research protocols. We prioritize our employees by offering competitive...